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<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<META NAME="Author" CONTENT="Curt M. Robinson">
<title>e-Financial Guest Book</title>
</head>
<body bgcolor="White">
<form method=post action="/cgi-bin/guestbook.cgi">
<input type=hidden name="book" value="book.htm">
<table border="0" cellpadding="0" cellspacing="0" width="0">
<tr>
<td><img src="spacer.gif" width="480" height="5"></td>
</tr>
<tr>
<td width="510">
<p align="right">
<font size="4" face="Times New Roman">Guest Book</font></p>
<hr>
<h3 align="center"><font size="3">Thank you for taking the time to let us know who you are.</font></a></h3>
<table border="0" width=75>
<tr>
<td><b>Name *</b> <br>
<input type="text" size="60" name=realname></td>
</TR>
<TR>
<td><b>E-Mail Address *</b> <br>
<input type="text" size="60" name=username></td>
</TR>
<TR>
<td><b>Company</b> <br>
<input type="text" size="60" name=company></td>
</tr>
</TABLE>
<TABLE>
<tr>
<td><b>Additional Comments or Questions:</b><br>
<textarea name=comments rows="8" cols="54"></textarea>
</td>
</tr>
</table>
* These values are required.<P>
<HR>
All information collected is for the exclusive use of e-Financial, Inc. We do not sell, trade or rent your personal information to others.
If you have any questions about our privacy policy, please contact us as <a href="mailto: privacy@efin.com">privacy@efin.com</a>.<br>
<HR>
<center><input type="submit" name="Register" value="Register">
<input type="reset" name="Reset Registry" value="Reset Form">
</center>
</form>
</body>
</html>